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Background: This study aimed to assess abnormalities in the insular cortex of individuals suffering from migraines and examine their associations with pain duration, medication usage, and clinical symptoms., Methods: We analyzed radiological data from 38 migraine patients who had undergone 3D iso T1-weighted brain MRI at our university hospital between 2019 and 2023. Structured questionnaires were used to collect information on participants' age, migraine type, disease duration, clinical symptoms, and medication use. Volumetric analysis was performed on the insular regions using Volbrain and 3DSlicer. The results were statistically analyzed., Results: Comparing groups with chronic pain to normal groups revealed significant differences in several insular regions, including the posterior insula (p = 0.034), parietal operculum (p = 0.04), and the entire insular cortex (p = 0.023). Further group comparisons (Group 1, 2, and 3) showed significant differences in specific insular regions. For instance, the anterior insula (p = 0.032) was associated with taste changes, the posterior insula (p = 0.010) with smell-related changes, and the central operculum (p = 0.046) with sensations of nausea. Additionally, significant changes were observed in the parietal operculum concerning nausea, photophobia, phonophobia, and changes in smell., Conclusion: To the best of our knowledge, there have been no studies investigating the relationship between clinical manifestations and volumetric correlation. This study provides insights into abnormalities in the insular cortex among migraine patients and their potential relevance to pain duration, severity, and migraine type. The results suggest that understanding alterations in insular regions possibly linked to pain could contribute to the development of innovative approaches to managing chronic pain., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: The morphology of the circle of Willis in adults has been thoroughly discussed in scientific literature. However, the morphology of the circle of Willis in pediatric patients is under-researched., Objectives: We aimed to establish reference data for the morphology and variations of the circle of Willis in a population consisting of all pediatric age subgroups and to evaluate the possible temporal evolution of the circle of Willis in pediatric patients along with the variations between pediatric and adult populations., Materials and Methods: Our patient cohort included 263 pediatric patients ages 1-215 months. A total of 273 magnetic resonance (MR) angiography images were retrospectively analyzed for all circle of Willis vessels to compare the incidence of complete cases and variation frequency based on gender and age group., Result: In our study of 273 MR angiograms from all age ranges in the pediatric population, we found a 56.1% circle of Willis completion rate. Overall completion rates were statistically significantly higher in the toddler and preschool age groups. The lowest completion rate was in the newborn-infant group (40%)., Conclusion: Circle of Willis completion rates and variations in pediatric populations are similar to those in adult populations; completion rates rise in toddler and preschooler age groups and decline as children grow into the school-age and adolescent period., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

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Background: Buccal mucosa metastasis is rare in breast cancer patients. Case Presentation: A 50-year-old female breast cancer patient with invasive lobular carcinoma (ILC) in his eight years follow-up period presented with a swelling in the right eye. Head and neck MRI was showed soft tissue formation with dimensions of 59x31 mm was detected in the axial plane, extending from the level of the right infratemporal fossa to the right buccinator muscle and right maxillary sinus in front of the alveolar process. In the right periorbital region, there was a thickness increase of up to 1 cm in the thickest part of the globe, which was evident in the anterolateral. In addition, there was no bone destruction in the right infratemporal region in maxillofacial CT, and no additional organ metastasis was detected in PET-CT performed for systemic scanning. In the histopathological examination of the tissue, carcinoma infiltration was detected. Radiotherapy was applied to the right buccal and orbital region of the patient as 30 Gy in 12 fractions (2.5 Gy per fraction) with volumetric modulated arc therapy technique and then 15 Gy in 6 fractions (2.5 Gy per fraction) boost radiotherapy with the adaptive technique were applied. At the follow-up 2 months later, clinical response was observed in the patient, and significant regression of the lesion was observed in facial and orbital MRI. At the 15th month follow-up of the patient, clinical and radiological remission continues. All clinical complaints regressed. Conclusion: ILC is a subtype of breast cancer that is characterized by unusual metastasis. Therefore, during the follow-up of these patients, it is necessary to monitor both laboratory values and clinical complaints very carefully. [ABSTRACT FROM AUTHOR]